Medications Associated With Falls in the Elderly

The table below lists some medications that have been associated with falls in the
elderly.

Medication

Potential adverse effects of medication

contributing to falls

Antidepressants e.g. amitriptyline,

clomipramine, dosulepin, imipramine,
fluoxetine, citalopram

Drowsiness, dizziness, confusion, postural

hypotension, visual disturbances
(SSRIs are less sedating and are associated with
fewer antimuscarinic and cardiotoxic side effects
than tricyclic antidepressants)

Antipsychotics e.g. haloperidol,

risperidone, quetiapine, clozapine

Postural hypotension, drowsiness, unsteady gait,

confusion

Antimuscarinic (anticholinergic) drugs

e.g. atropine, hyoscine, orphenadrine,
procyclidine, trihexyphenidyl

Drowsiness, dizziness, confusion, blurred vision

Benzodiazepines e.g. diazepam,

temazepam, nitrazepam

Drowsiness, unsteady gait, confusion

Non-benzodiazepine hypnotics
(Z Drugs) e.g. zopiclone, zolpiderm

Drowsiness, unsteady gait, confusion

Dopaminergic drugs used in Parkinsons

disease e.g. co-beneldopa,
co-careldopa, bromocriptine, ropinirole,
pramipexole, rotigotine

Sudden onset of sleep, postural hypotension,

confusion

Angiotensin-converting enzyme (ACE)

inhibitors e.g. captopril, ramipril,
enalapril, lisinopril

Dizziness, postural hypotension

Angiotensin-II receptor antagonists e.g.

candesartan, irbesartan, losartan

Dizziness, postural hypotension

Alpha-blockers e.g. doxazosin, prazosin

Dizziness, postural hypotension

Anti-arrhythmics e.g. digoxin,

amiodarone, flecainide

Bradycardia, arrhythmias, dizziness

Antiepileptic drugs e.g. phenytoin,

carbamazepine

Dizziness, drowsiness, confusion, visual

disturbances
(confusion, visual disturbances and ataxia may be
signs of phenytoin toxicity)

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Beta-blockers e.g. propranolol, atenolol,

sotalol

Dizziness, postural hypotension

Diuretics e.g. furosemide, bumetanide,

bendroflumethiazide

Dizziness, postural hypotension

Opioid analgesics e.g. morphine,

codeine, dihydrocodeine, tramadol

Drowsiness, dizziness, confusion, postural

hypotension, visual disturbances

Sedating antihistamines (including those

in OTC medicines) e.g. promethazine,
chlorphenamine

Confusion, dizziness, drowsiness, blurred vision

Calcium-channel blockers e.g.

amlodipine, felodipine, nifedipine,
diltiazem, verapamil

Dizziness, postural hypotension

Nitrates e.g. glyceryl trinitrate, isosorbide

mononitrate, isosorbide dinitrate

Dizziness, postural hypotension

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